Shuang Zhang1, Yan Hu1, Lu Zhou1, Xiaojing Chen1, Yan Wang1, Jiayu Wu1, Huimin He1, Yanhong Gao2. 1. Department of Geriatrics, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, PR China. 2. Department of Geriatrics, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, PR China. Electronic address: yhgao2010@yahoo.com.
Abstract
OBJECTIVES: The aim of this study was to investigate the association between PTH and Nt-proBNP in elderly patients with CHF in an attempt to gain insights into the role of PTH in a community-based cohort of elderly patients with CHF. METHODS: A total of 182 consecutive CHF patients with follow-up for mortality after 3 years were prospectively studied. Serum levels of intact PTH, Nt-proBNP and biochemical parameters were examined. The enrolled patients were divided into groups by the levels of PTH and New York Heart Association (NYHA) functional classes. RESULTS: A total of 66 (36%) patients had PTH values above the upper limit of the normal range. Serum creatinine (p=0.001), estimated glomerular filtration rate (eGFR) (p=0.001), Nt-proBNP (p<0.001), serum calcium (p=0.030), heart rate (p=0.002) showed statistical significance in different stages of PTH. The mean PTH and Nt-proBNP levels increased as the NYHA functional class increased. The optimal cut-off value of PTH to predict CHF-related death was 48.98 pg/ml, with 57.14% sensitivity and 86.24% specificity. The best cut-off point of Nt-proBNP was 480 ng/ml with 76.47% sensitivity and 80.48% specificity. Over a mean follow-up of 3 years, Kaplan-Meier survival curves demonstrate that patients with higher levels of intact PTH had lower survival time, with a hazard ratio of 2.5 (95% CI 1.5-3.9). CONCLUSIONS: The study has shown that serum intact PTH level obtained in the elderly patients with CHF is a novel biomarker associated with Nt-proBNP and could provide supplementary information for the diagnosis and prognostic prediction of CHF, especially when it is used in combination with Nt-proBNP.
OBJECTIVES: The aim of this study was to investigate the association between PTH and Nt-proBNP in elderly patients with CHF in an attempt to gain insights into the role of PTH in a community-based cohort of elderly patients with CHF. METHODS: A total of 182 consecutive CHFpatients with follow-up for mortality after 3 years were prospectively studied. Serum levels of intact PTH, Nt-proBNP and biochemical parameters were examined. The enrolled patients were divided into groups by the levels of PTH and New York Heart Association (NYHA) functional classes. RESULTS: A total of 66 (36%) patients had PTH values above the upper limit of the normal range. Serum creatinine (p=0.001), estimated glomerular filtration rate (eGFR) (p=0.001), Nt-proBNP (p<0.001), serum calcium (p=0.030), heart rate (p=0.002) showed statistical significance in different stages of PTH. The mean PTH and Nt-proBNP levels increased as the NYHA functional class increased. The optimal cut-off value of PTH to predict CHF-related death was 48.98 pg/ml, with 57.14% sensitivity and 86.24% specificity. The best cut-off point of Nt-proBNP was 480 ng/ml with 76.47% sensitivity and 80.48% specificity. Over a mean follow-up of 3 years, Kaplan-Meier survival curves demonstrate that patients with higher levels of intact PTH had lower survival time, with a hazard ratio of 2.5 (95% CI 1.5-3.9). CONCLUSIONS: The study has shown that serum intact PTH level obtained in the elderly patients with CHF is a novel biomarker associated with Nt-proBNP and could provide supplementary information for the diagnosis and prognostic prediction of CHF, especially when it is used in combination with Nt-proBNP.
Authors: G Loncar; B Bozic; N Cvetinovic; H-D Dungen; M Lainscak; S von Haehling; W Doehner; Z Radojicic; B Putnikovic; T Trippel; V Popovic Journal: J Endocrinol Invest Date: 2016-10-13 Impact factor: 4.256